153医院对法定传染病实时监控干预的方法与成效

<正>目前全球传染病流行情况十分严峻,新老传染病对健康的威胁交替发生。我国是传染病高发国家,做好传染病防控工作十分重要。监测与预警是控制、降低或减少传染病等突发事件危险危害的关键所在,是实施从源头上治理危害的理论保障[1]。2008年以来,笔者所在医院对法定传染病管理关口前移,开展实时监控和预警干预,形成了"监测危险因素-预警提示-按时限报告-预防控制医院感染"四位一体的管理模式。经过5年实践,传染病疫卡网络直报及时率由95%提     

医院感染实时监控系统的实际应用与思考

<正>医院感染管理是医院医疗质量和医疗安全管理的重要组成部分和关键环节,管理的成效已成为评价医院综合医疗质量的一项重要指标[1]。为保证医院感染管理质量,提升管理效率,笔者所在医院采用杭州杏林信息科技有限公司研制的医院感染实时监控系统(RT-NISS)作为对医院感染管理的技术补充[2,3]。通过近1年的应用,改变了医院感染管理以回顾性调查、手工处理监测数据为主,工作效率低的状况,实     

用理念指导护理实践从实践中升华护理理念

护理理念是指引护理人员思考和行动的价值观与专业信念。作者在管理实践中用护理理念引导护理人员转变观念，并取得了良好效果：(1)凝练了护理人员的职业精神；(2)构筑了提高质量的内在素质；(3)规范了护士工作的行为标准。在实践过程中，作者体会到：(1)制定理念要注重实用效果；(2)实践理念要体现锤炼原则；(3)提升理念要调节双向作用。     

中小型医院护理人员对整体护理培训需求的调查研究

对19所军队中小型医院开展整体护理科室的473名护士及护士长进行问卷调查，旨在了解对整体护理理论与技能培训需求的情况。经统计学处理，被调查对象有很高的需求，且不同职务者没有差异。从而分析阐述了对护理人员进行系统地整体护理理论与技能培训的紧迫性、必要性和相应对策，以促进整体护理的开展和内在质量的提高。     

从集体食物中毒事件处置谈感染管理科职能作用

目的探索医院应对突发公共卫生事件的方法。方法通过分析感染管理人员在处置一起百余人食物中毒事件过程中的作用,探讨感染管理科在医院应对突发公共卫生事件中所发挥的职能。结果感染管理人员主动参与,使突发公共卫生事件从预警报告、患者分类救治到流行病学调查及紧急应对等环节得到妥善处置。结论感染管理科应成为医院处置突发公共卫生事件的职能科室,同时感染管理人员应掌握突发公共卫生事件处置程序和有关法规,全程参与并积极发挥职能作用,是医院有效应对突发公共卫生事件的重要保障。     

经皮穿刺腰椎椎间固定融合术的初步临床应用

Objective To characterize the feasibility, key technology, indications and clinical outcome of percutaneous lumbar interbody fusion. Methods Clinical data from 32 cases [16 made, 16 female, age range 31-77 years, average disease duration (5.0±2.0) years ] underwent percutaneous nucleotomy and endplate curettage was retrospectively analyzed. After percutaneous nucleotomy and endplate curettage, one expandable spinal spacer B-twin was introduced into the intervertebral space and some allograft cancellous bone implanted around the B-twin. Indications for treatment included degenerative lumbar disc herniation (LDH) with intervetebral distability or Ⅰ degree spondylolythesis (21 cases), LDH with intervetebral space collapse (10 cases) and lumbar discogenic pain (1 case). The symptoms and function of all patients were evaluated before, 3 months and 12 months after the operation by clinical outcome judgment criterion of surgical treatment for low back pain formulated by JOA, and the rate of clinical improvement and treatment efficacy were calculated. The JOA scales preoperatively, postoperatively and on the final follow-up was compared using ANOVA in SPSS. The changes before and after surgery with the JOA score and the the rate of clinical improvement between 3 months and 12 months after the operation was also compared using χ2 test. Results The average operation time 1 hour and blood loss < 20 ml, Surgical site: L3-4 4 cases, L4-5 19 cases, I5-S1 6 cases, L3-4 and L4-5 3 cases, B-TWIn were implanted fusion cage 35, in three cases of intervertebral space with two implantso Average in Hospital time was (10.0±2.1) d . Complication included 1 case with displacement and 1 case with secondary instability of next intervertebral space. All the patients were evaluated after a follow-up of 3-36 months (average 13 months) 32 cases of patients with low back pain JOA score: before surgery is(4.1±1.8), 3 months after surgery is (11.9±3.9), 1 year after surgery of the 22 cases is (12.0±3.2). Score before and after surgery were statistically significant differences (F = 5.67, P < 0.01). The rate of clinical improvement After surgery there was no significant difference (F = 4.18, P > 0.05). Conclusions Percutaneous posterior lumbar interbody fusion with B-twin expandable fusion cage could lead to satisfactory outcome in the treatment of degenerative disc disease and intervertebral instability,which minimize surgical soft tissue and trauma spinal damage, does not destroy the structure of spinal stability. The technique The long-term outcome, complications and fusion rate need further observing.     

中小型医院护士长功能发挥情况调查及其影响因素研究

目的 评价临床科护士长整体功能发挥水平、影响因素及存在的薄弱环节。方法 采取多角度问卷调查法对１１所医院的１１７名护士长进行调查并经统计处理。结果 临床科护士长整体素质及功能发挥水平较好,检验证明,临床科护士长功能发挥与学历、职称、任职年限及任护士工作年限相关。提示 选拔培养护士长应把握的环节。     

中小型医院护理人员健康教育培训需求的调查与思考

通过对19所军队中小型医院的473名护士及护士长进行健康教育培训需求问卷调查，旨在了解护理人员对健康教育理论与技能培训需求的情况。经统计学处理，被调查对象有很高的需求，且不同职务间没有差异。从而分析阐述了对护理人员进行系统地健康教育理论与技能培训的重要性和紧迫性，提出相应的对策，以促进健康教育的开展和内涵质量的提高。     

高龄急性心肌梗死心肺脑复苏后的心理护理

现代研究证明，精神紧张和剧烈的情绪波动是诱发急性心肌梗死(AMI)并影响其康复的危险因素。2001年5月我院救治了1例74岁因车祸致伤诱发大面积AMI、频发心跳呼吸骤停的病人，复苏后适时给予个体化的心理护理，顺利康复，现将心理护理体会报告如下。